The Role Of Progesterone In Maintenance Therapy Following Arrested Preterm Labour : A Randomized Controlled Trial

Abstract

Background and objective ABSTRACT Progesterone has long been considered as an important agent in the maintenance of uterine quiescence and has been used extensively in primary and secondary prevention of preterm delivery. The present study was aimed to determine the role of vaginal micronized progesterone ( 400 mg ) in prolonging the latency period upto 37 weeks of gestation in patients with arrested preterm labour. Methodology This study was a randomized controlled trial conducted in the Department of Obstetrics and Gynaecology, KLES Dr. Prabhakar Kore Charitable Hospital and Medical Research Centre, Belgaum. A total of 98 pregnant women fulfilling the inclusion criteria were included in this study. Based on computer generated random numbers, these women were randomized into two groups of 49 each, namely study group ( Group S ) which received 400 mg of vaginal micronized progesterone and control group ( Group C ) which did not receive any drug. Results Of the 98 patients, four from group C and one from group S were lost to follow up. The mean age of the women in group S was 22.73±3.47 years and in group C it was 24.55±4.14 years. The mean period of gestation at delivery was significantly high in group S ( 37.25±2.51 weeks) . The recurrence of preterm labour was significantly high in the group C as 71.11% of the women delivered before 37 weeks of gestation compared to only 41.66% in group S. Majority of III women ( 25% ) had a latency period between 36 to 42 days in group S. In group C 57.78% had latency period of < 7 days ( p<0.001) . The mean latency period in group S was significantly higher in group C ( 28.77±15.95 days; p<0.001 ) . Conclusion Maintenance tocolytic therapy with vaginal micronized progesterone ( 400 mg ) in patients with arrested preterm labour significantly prolonged the latency period and reduced the recurrence of preterm labour.